With the practice of law becoming more and more globalized, business lawyers in the United States are increasingly seeking pro bono opportunities abroad. A U.S. business lawyer looking to the People's Republic of China for such opportunities should be prepared for a challenging but very rewarding professional experience. As an associate in the Hong Kong office of Troutman Sanders LLP, I have the privilege of providing pro bono legal services to Operation Smile China Medical Mission Limited (Operation Smile HK), the Hong Kong chapter of the Norfolk-based Operation Smile International. Operation Smile HK provides free medical treatment for children in China born with a cleft lip and/or a cleft palate.

Operation Smile HK was incorporated in Hong Kong in 1991. At the time, there was no legal framework under which a foreign nonprofit could operate in China. Fortunately, that changed in June 2004 with the enactment of the People's Republic of China's Regulations on the Administration of Foundations. Since then, the Chinese government has been allowing domestic nonprofit organizations to be set up in China. It still can be a challenge, however, for U.S.-headquartered charities to establish themselves in China as foreign nonprofits. Lawyers assisting foreign nonprofits must cut through red tape, work with the various ministries and Chinese authorities, and always be aware of the prevailing political climate. It can take time for a foreign nonprofit organization to build trust with local Chinese governments.

I found this to be especially true while helping Operation Smile HK prepare for its missions. Before Operation Smile HK conducts a medical mission at a new site, its medical, logistical, and administrative coordinators must carry out thorough fact-finding with the designated local hospital. The partnership with local hospitals is important, as they provide the hardware for the medical mission--hospital beds, operating theatres, and other necessities. Terms of agreement, a timeline, and an action plan need to be prepared at least six months before a mission takes place. The terms of agreement require a delineation of responsibilities between the local hospital and Operation Smile HK, with the hospital providing its facilities and Operation Smile HK being responsible for the medical operations and the expenses of the entire medical mission.

Besides negotiations with the local hospital, extensive discussions with various governmental departments at both the local township and the provincial level are also necessary. For instance, counsel must work with local authorities to ensure that Operation Smile HK's standard medical equipment, donated medical supplies, and gifts are shipped into China on a timely basis. In one case, a shipment of Operation Smile HK medical supplies was held up for 12 months at Liaoning port due to local red tape. Certain donated pharmaceuticals were refused entry as they were not categorized in accordance with Chinese medical practice. On another occasion, a hefty customs charge was levied on a container with donated toys. These types of incidents stem from a system inexperienced with nonprofit work, especially nonprofit work that originates from overseas. The pro bono lawyer must strive to understand how the existing Chinese system works, be able to read between the lines in interpreting Chinese rules and regulations, be adept in negotiating with various governmental departments, and be politically sensitive at all times.

Although China has had a late start in the area of nonprofit regulation, it is learning quickly, and officials are gaining a better understanding of volunteerism and nonprofit activities each day. Troutman Sanders is now helping Operation Smile HK become a domestic nonprofit organization, which should greatly improve its ability to bring medical services to the children of China. In the first 16 years of its existence, Operation Smile HK sent medical teams to 24 cities in China, and provided necessary medical or surgical treatment to over 9,000 children. As China's nonprofit legal framework matures and the cultures of volunteerism and charity develop, I look forward to seeing Operation Smile HK reach more children in need and change their lives for the better.